A 12-year-old SF Australian shepherd mix with a history of vomiting small pieces of rubber toy was presented for vomiting. Physical examination and blood work were both normal. Survey radiographs showed a intra-gastric soft tissue opacity.
A 12-year-old SF Australian shepherd mix with a history of vomiting small pieces of rubber toy was presented for vomiting. Physical examination and blood work were both normal. Survey radiographs showed a intra-gastric soft tissue opacity.
Mural pyloric mass or abscess
The stomach in this patient was thickened with a mural mass or possible abscess at the caudal aspect of the pyloric antrum and measures approximately 2.5 cm. This impinged upon the pyloric outflow. There was some retention of ingesta, which is indicative of delayed outflow. There was no evidence of foreign bodies noted as this is an intramural lesion. The small intestine and colon were unremarkable. The curvilinear patterns were respected.
Surgical intervention is recommended. Endoscopy may be helpful; however, the mass appears to be intramural and therefore may be unremarkable from a scope standpoint. For full resection Bill Roth procedure would likely be necessary with gastroduodenal resection and anastomosis. Differentials include mural abscess, carcinoma or muscle based tumor with a minor potential for round cell neoplasia. There was no significant regional lymphadenopathy noted to suggest metastatic disease. Ultrasound-guided FNA or drainage could be considered as well, but this may be somewhat difficult given the angle. The structure would be more suggestive for abscess with the potential of underlying neoplasia. I would recommend surgical approach assuming this is abscess until histopathology and surgical results can be obtained.
Gastric foreign body, neoplasia, granuloma
Ultrasound-guided FNA or drainage could be considered, but this may be somewhat difficult given the angle
